Rebound of Reflux-Related Symptoms After Helicobacter pylori Eradication in Patients With Gastroesophageal Reflux Disease: A Prospective Randomized Study

IF 4.3 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Helicobacter Pub Date : 2025-02-26 DOI:10.1111/hel.70023
Kai-Yu Hu, Ping-Huei Tseng, Jyh-Ming Liou, Chia-Hung Tu, Chien-Chuan Chen, Yi-Chia Lee, Han-Mo Chiu, Ming-Shiang Wu
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引用次数: 0

Abstract

Background/Purpose

We aimed to assess the effects of Helicobacter pylori (H. pylori) eradication on the rebound of reflux-related symptoms among gastroesophageal reflux disease (GERD) patients.

Methods

This prospective randomized study recruited patients with typical reflux symptoms and reflux esophagitis on esophagogastroduodenoscopy (NCT02934152). Patients positive for H. pylori via a urea breath test (UBT) were randomly assigned to receive bacterial eradication with triple therapy for 2 weeks either before or after proton-pump inhibitor (PPI) treatment for 4 weeks. Follow-up was implemented with serial GerdQ evaluation and a subsequent UBT. The primary outcome was the incidence rates of symptom rebound between patients with and without H. pylori infection. The secondary outcomes included the severity of symptom rebound, incidence rates of symptom rebound, and successful eradication rates between the early and late eradication groups.

Results

A total of 248 patients were enrolled, of whom 107 (43.1%) tested positive for H. pylori infection. All patients with and without concurrent H. pylori infection had significant symptom improvement over the entire treatment. Patients with H. pylori infection had significantly lower rates of symptom rebound (19.8% vs. 34.2%, p = 0.034) and rebound severity (1.8 ± 0.7 vs. 2.8 ± 1.6, p = 0.031) 4 weeks after eradication and PPI treatment than those without. The incidence rates of symptom rebound and successful eradication rates were not significantly different between the early and late eradication groups.

Conclusions

GERD patients with concurrent H. pylori infection were less susceptible to symptom rebound after H. pylori eradication compared to those without.

Trial Registration

ClinicalTrial.gov (NCT02934152)

胃食管反流病患者根除幽门螺杆菌后反流相关症状的反弹:前瞻性随机研究
背景/目的我们旨在评估幽门螺杆菌根除对胃食管反流病(GERD)患者反流相关症状反弹的影响。方法本前瞻性随机研究招募食管胃十二指肠镜检查有典型反流症状和反流性食管炎的患者(NCT02934152)。通过尿素呼气试验(UBT)检测幽门螺杆菌阳性的患者被随机分配在质子泵抑制剂(PPI)治疗4周之前或之后接受2周的细菌根除三联疗法。通过连续GerdQ评估和随后的UBT进行随访。主要观察指标是有无幽门螺杆菌感染的患者之间症状反弹的发生率。次要结局包括症状反弹的严重程度、症状反弹的发生率以及早期和晚期根除组之间的根除成功率。结果共纳入248例患者,其中幽门螺杆菌感染阳性107例(43.1%)。所有合并或不合并幽门螺杆菌感染的患者在整个治疗过程中症状均有显著改善。幽门螺杆菌感染患者在根除和PPI治疗4周后症状反跳率(19.8% vs. 34.2%, p = 0.034)和反跳严重程度(1.8±0.7 vs. 2.8±1.6,p = 0.031)显著低于未治疗的患者。症状反弹发生率和根除成功率在早期和晚期根除组之间无显著差异。结论伴有幽门螺杆菌感染的胃食管反流患者在根除幽门螺杆菌后较未感染幽门螺杆菌的患者更不易出现症状反弹。临床试验注册网站(NCT02934152)
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来源期刊
Helicobacter
Helicobacter 医学-微生物学
CiteScore
8.40
自引率
9.10%
发文量
76
审稿时长
2 months
期刊介绍: Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.
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